In vivo assessment of changes to canine airway smooth muscle volume following bronchial thermoplasty with OR-OCT

In vivo assessment of changes to canine airway smooth muscle volume following bronchial thermoplasty with OR-OCT

The inability to assess and measure changes to the airway smooth muscle (ASM) in vivo is a major challenge to evaluating asthma and its clinical outcomes. Bronchial thermoplasty (BT) is a therapy for asthma that aims to reduce the severity of excessive bronchoconstriction by ablating ASM. While mult...

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Bibliographic Details
Published in:Journal of applied physiology (1985) 2021-04
Main Authors: Adams, David C, Holz, Jasmin A, Szabari, Margit V, Hariri, Lida P, Mccrossan, Andrew F, Manley, Christopher J, Fleury, Sean, O'Shaughnessy, Seamus, Weiner, Jason, Suter, Melissa J
Format: Article
Language:eng
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Summary:The inability to assess and measure changes to the airway smooth muscle (ASM) in vivo is a major challenge to evaluating asthma and its clinical outcomes. Bronchial thermoplasty (BT) is a therapy for asthma that aims to reduce the severity of excessive bronchoconstriction by ablating ASM. While multiple long-term clinical studies of BT have produced encouraging results, the outcomes of BT treatment in practice have been variable, and questions remain regarding the selection of patients. Previously we have demonstrated an imaging platform called orientation-resolved optical coherence tomography that can assess ASM endoscopically using an imaging catheter compatible with bronchoscopy. In this work, we present results obtained from a longitudinal BT study performed using a canine model (n = 8) and with the goal of investigating the use of OR-OCT for measuring the effects of BT on ASM. We demonstrate that we are capable of accurately assessing ASM both before and in the weeks following the BT procedure using blinded matching to histological samples stained with Masson's Trichome (p < 0.0001, r = 0.79). Analysis of volumetric ASM distributions revealed significant decreases in ASM in treated airways (average cross-sectional ASM area: 0.245 ± 0.145 mm pre-BT and 0.166 ± 0.112 mm 6 weeks following BT). These results demonstrate that OR-OCT can provide clinicians with the feedback necessary to better evaluate ASM and its response to BT, and may potentially play an important role in phenotyping asthma and predicting which patients are most likely to respond to BT treatment.
ISSN:1522-1601